Antipsychotics & Breastfeeding
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Q:  Do you know if there are any meds out there that treat hallucinations that can be taken while breastfeeding?

Dear Ms. W' -- 
I can never remember for sure so I always look up answers to questions like these.  Most sources seem to agree:  Haldol and other old generation antipsychotics are not regarded as safe in breastfeeding.  And the newer ones, like Zyprexa, have not been around long enough to be studied well enough to make people think they're clearly okay.  Some of them have clear information indicating that they're not safe in breastfeeding.  Here's a
recently updated summary.  The third page in the table covers antipsychotics.  You'll see that none, old generation or new, are clearly safe.  

Note on the second page, the list of mood stabilizers:  Depakote is listed as "safe" in breastfeeding.  If you have bipolar disorder, there is some evidence that Depakote can have an antipsychotic effect.  This is not a standard maneuver, that you'd have to discuss in detail with your doctor (I've heard some express some doubt about this safety rating:  too few patients in the sample, even though the American Academy of Pediatrics has approved it) but that's about the only option you could try that I know of.  Otherwise, as you've probably been told, you'd have to "stop breastfeeding".  

Dr. Phelps

Published December, 2002 


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